FDA Adverse Event Malfunction Summary report: N

MAT; MECHANICAL ADVANTAGE TOURNIQUET

MDR report key: 1714753 · Received June 2, 2010

Report

Report Number
9615387-2010-00005
Event Type
Malfunction
Date Received
June 2, 2010
Date of Event
May 12, 2010
Report Date
June 2, 2010
Manufacturer
PYNG MEDICAL CORP.
Product Code
GAX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED TO PYNG MEDICAL.

Description of Event or Problem · 1

DURING A TRAINING SESSION THE BUCKLE LOCKING THE STRAP INTO PLACE SLIPPED CAUSING THE DEVICE TO NOT STAY TIGHT AROUND THE ARM. NO PT WAS INVOLVED. PYNG (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MAT; MECHANICAL ADVANTAGE TOURNIQUET TOURNIQUET, NONPNEUMATIC GAX PYNG MEDICAL CORP. MAT 933

Patients

Seq Age Sex Outcome Treatment
1 Other